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7 week old fighting at the breast, short feedings, pain

My baby will be 7 weeks old tomorrow, he's only had breast milk. He's been a strong sucker with great feeding instincts from day one. I've had nipple pain throughout the entire time, but it was worse at the beginning. I had flat nipples that had to be kind of reshaped by a nipple shell. When I was in the hospital the lactation consultants said my latch was fine. Sometimes I think my nipple might be shaped wrong after a feeding, but I need to see pictures of what people mean when they say flat, slanted or lipstick shaped to tell, and I haven't been able to find any pictures online. I also have letdown pain and achy soreness between feedings. The letdown pain feels like strings pulling hard at various points in the breast toward the nipple, and pain in the second breast's nipple while I feed him at the first breast. Between feedings it feels like my bra is sandpaper or something. I can't stand for my breasts to be touched by anything ever at all, which is wonderful for my baby who wants to be held, not to mention my husband.

The big problem now, in addition to those pains, is that he's been fighting me while I feed him. Not every feeding, but several times a day. He pushes with his hands and kicks his legs and pulls back with his head, very forcefully, usually taking my nipple with him. He'll pull off entirely and make some fussy cries, and sometimes go back to it, chomping eagerly, and other times he'll be done. This makes our feedings sometimes very short, and that makes me worry that he's getting enough to eat. He might do only 5-10 minutes on each side, and sometimes refuses one side entirely.

I called a lactation consultant about this twice, and talked to two different ladies. The first said it was oversupply and an overly forceful letdown, so I should try different nursing positions. I did, but they weren't comfortable at all. They either required me to hold up his head, taxing my arm strength, especially when he was pushing against me, or when I lay on my back and put him on my belly the weight of his head on top of my breast was painful.

The second lactation consultant said I had a low supply and I had to try to get it back up. I think she thought that was the case because I said I'd taken sudafed. And she said that a baby's behaviors are the same for oversupply and undersupply.

You can imagine the effect these contradictory diagnoses have had on my faith in lactation consultants. I also don't believe anyone who says if you have a proper latch it won't hurt. Or at least I won't believe it until I experience a painless latch, which seems to me like a myth right now. I find it very discouraging to constantly hear I'm in pain because I'm doing it wrong. It feels like blaming the victim.

My mom, who breastfed 7 babies, says he's just an efficient feeder and he's getting all the nutrition he needs because he's growing and producing plenty diapers. She tells me to stop stressing and just feed him on demand and he'll be fine. We both feel like oversupply and overly strong letdown are more likely. We see milk overflowing the side of his mouth and hear the way he swallows it. I do still get painfully engorged sometimes. As long as he's getting what he needs, I'm ok with short feedings as long as he fully drains each breast at least once a day. That takes 20-25 minutes for me to feel relieved.

He was 7#3oz at birth and is now over 11#. Just looking at him you can tell he's much bigger. His limbs used to be skinny, but now he's filled out and has a double chin. People who see him once a week remark on how much he's grown.
He's making 8-10 wet diapers and 4-5 poopy a day. Half of the poopy diapers are yellow-gold, and half are greenish.

I feel like I need "rules" or guidelines of some kind to help me know what to do. These are the ones I've been following:
Feed him when he cries.
Feed him two hours from the end of the last feeding, if the last feeding was a good one. A good feeding is at least 20 minutes combined. If the last feeding was shorter than that, feed him again in 1 hour.
Don't wake him to feed, since he's growing and my supply is established. If he's sleeping when he's supposed to eat, feed him as soon as he wakes up, and pump in the meantime if necessary.
If he's fussing while I'm feeding him, try 3 times to get him to feed on that side, then give up. I can give up without trying 3 times if he's fed for 12 minutes on that side already.
Pump to relieve engorgement.

Do you ladies think the baby is getting the milk he needs?
Why is he fighting and fussing and how can I stop this behavior?
Are my guidelines ok or should I change any of them? Particularly, how much should I fight him back when he resists feeding? (I would love for an expert to give me permission to give up when he's making feeding him so hard, and try again later.)
Is there anything I can do to relieve these various pains I have? The pain between feedings and the letdown pain are worse that the nipple pain for me, and I feel even more helpless about those pains.

Re: 7 week old fighting at the breast, short feedings, pain

[QUOTE=@llli*Marjojo;1318812]He's making 8-10 wet diapers and 4-5 poopy a day. Half of the poopy diapers are yellow-gold, and half are greenish.

I feel like I need "rules" or guidelines of some kind to help me know what to do. These are the ones I've been following:
Feed him when he cries.
Feed him two hours from the end of the last feeding, if the last feeding was a good one. A good feeding is at least 20 minutes combined. If the last feeding was shorter than that, feed him again in 1 hour.
Don't wake him to feed, since he's growing and my supply is established. If he's sleeping when he's supposed to eat, feed him as soon as he wakes up, and pump in the meantime if necessary.
If he's fussing while I'm feeding him, try 3 times to get him to feed on that side, then give up. I can give up without trying 3 times if he's fed for 12 minutes on that side already.
Pump to relieve engorgement.

QUOTE]
Four lbs in seven weeks sounds like perfect weight gain and diapers are excellent. I wouldn't worry about low supply. It really does sound like you have OS/OALD. Your body will naturally start make less here in a few weeks. There are things to help in the meantime. Laidback nursing does not have to be all the way down. I never reclined more than 10-15 degrees. Use whatever position feels comfortable without being bent over baby causing gravity to make the milk flow faster. Use pillows to prop baby and your arm up if need be. Your baby is growing great so stop worrying about times so much. Feed whenever baby cues. Crying is a late sign of hunger. Look for rooting, fist/arm chewing, lip smacking/licking. Pump or hand express only enough to feel relieved. By emptying your breasts completely more often than baby is, you are telling your body to make more milk. You want the opposite. I used ice packs on my breasts for 10-20 minutes if I could time it right or iced one side down while he fed on the other. It really helps with tenderness and slowed the flow down so he wasn't so fussy. Its totally normal for a baby to be finished in 5-10 minutes and only eat from one side. He may really not be hungry. ds is up. gotta go

Re: 7 week old fighting at the breast, short feedings, pain

Have you had any hands on help, preferably from an IBCLC? Nursing should not be painful! Has latch been evaluated in person, or have you only talked on the phone with an LC? Has baby been checked for tongue tie?

Pain when even your bra touches your nipples makes me wonder about thrush or vasospasm. Are your nipples cracked, scaly, or very pink? Any antibiotics during labor or afterwards? What color are your nipples after nursing, and do they ever change color?

Re: 7 week old fighting at the breast, short feedings, pain

Thanks for confirming the oversupply diagnosis! It is good to at least know what the problem is!

It's good to know that those laidback positions don't mean all the way on your back! I tried a slightly reclining position and I guess it was better, but then the next time he was back to crying and fighting. There really is no pattern or way to make sense of it.

So should I continue offering the breast every hour while the baby is doing these short feedings? I'd like to have more freedom than that, to feel like I can leave him with someone else for longer than a single hour if I need to. I wonder if getting these little snacks every hour keeps his little belly half full, so he never wants to fill it with a longer feeding. I would love for someone to give me permission to feed every two hours or on demand, regardless of the length of the last feeding.

I was evaluated in person by at least 3 LCs in the hospital. Then my pediatrician looked at my latch again at my first appointment with her. I didn't enjoy any of these "hands on" interactions because I felt like I was being manhandled. For example, the pediatrician broke the latch for me in a kind of rough way. I don't know whether or not the baby has been checked for tongue tie, as no one explicitly ever told me they were doing that, but since several people watched him feed and didn't say anything about that, I assumed he was fine and any problem was on my end. My mom has seen me feed him several times in his first five days, then again at two weeks, and this past weekend. I consider her an amateur expert.

My nipples are pink. What's "very pink"? They're not scaly, no dry skin. I don't know what "cracked" nipples look like. Again, I need pictures to understand these descriptions. They don't really change color, just shape. No antibiotics since before the pregnancy.

Re: 7 week old fighting at the breast, short feedings, pain

Also, I have trouble getting comfortable in the side-lying position. What do you do with your bottom arm? It seems like it's in the way or getting crushed by my body or the baby. I usually need to use both hands to hold the baby and the breast and that position kind of puts one arm out of commission. In theory I see how it could be really comfortable, but I haven't been able to make it work for me.

Re: 7 week old fighting at the breast, short feedings, pain

If baby is gaining well, and diaper output is good, feeding on demand is usually the best way to go. Some babies do feed faster than others, particularly if mom has oversupply, which it sounds like you have.

Baby would not have been checked for tongue tie unless someone looked in baby's mouth. And cracks in your nipples would be sort of like wounds--actual damage to the tissue. The bottom line is, nursing should not hurt you! I would highly recommend seeing an IBCLC to evaluate your pain issues. It doesn't matter how "good" the latch looks from the outside, if nursing hurts, SOMETHING is wrong. Maybe not latch, maybe thrush or vasospasm, but the best way to figure this out is with good hands on care.

As for side lying--I have never been able to really do it the "traditional" way shown in pictures, because I am small breasted and my nipple does not reach baby very well if I do that. In my case, I have to prop baby's head on my arm to make it work. Most nursing positions require a little bit of experimentation from mom to mom to figure out what works!

Re: 7 week old fighting at the breast, short feedings, pain

While feeding overnight, I was looking especially for the things you mentioned and noticed that the very tip of the nipple was white, just for a minute after taking it out of his mouth, then it changes back to pink. That was probably an especially bad feeding because I was engorged and that makes it harder for him to get more than just the tip in his mouth. Sometimes I pump a little before feeding for that reason.

They never looked at his mouth while I was there but they did lots of tests and things in the nursery so maybe they looked there. I guess I assumed they'd know if they needed to look and look, and if they didn't look it was because things were fine

I might have cracks in the nipples but I'm not sure. Are there any online resources that show photos of various nipple issues?

Can an LC help with the other pains I'm having besides the nipple stuff? Assuming I don't have thrush or something, what can they do about letdown pain and general achiness? I could stand pain during feedings if I could be pain-free between them. It's the inescapable-ness, never-ending-ness that's getting to me.

Re: 7 week old fighting at the breast, short feedings, pain

An IBCLC should be able to help you figure out why you are having your pain, yes. And as far as I know, most routine nursery care does not involve checking baby for tongue or lip ties.

The tips of your nipples turning white does make me think a bit about latch problems, or vasospasm--I hope someone who can post links easily can link you to info about those issues, because I am using my phone on a pumping break and it will not let me link! I also don't know of any online resource with pictures of various nipple concerns myself, but perhaps someone else does? Either way, a board certified IBCLC should be able to help with all of these concerns, so I still highly recommend one!

Re: 7 week old fighting at the breast, short feedings, pain

I have a 2 week old and I am having similar problems with her latch as far as sometimes my nipples have a bit of white at the tip and I also have 2 hot spots, 1 on each nipple that just will NOT heal. I know that I am not using proper positioning to breastfeed because my upper back is sore, my breasts are sore from the strain. She is a STRONG nurser and I have to literally stuff my breast into her mouth to get her to take more than my nipple-which is not petite anymore, like her little tiny mouth. I break the latch a few times throughout because like you said Marjojo, she likes to wiggle around and move away from the areola to just my nipple-this is because my milk letdown is very fast and even though she can eat quickly, it sometimes overwhelmes her, and sometimes she just wants to suckle but not eat much.

But I wanted to suggest that you pursue the possibility of your 7 week old having acid reflux. My daughter, now 3 had HORRIBLE acid reflux that took 3 months to diagnose and because it took so long she is still a very hesitant eater. She would latch, pull back, pop off, scream, arch her back and go into fits. It was NOT because she was not getting milk. Although it took her a while to get back to her birth weight, she was peeing and pooping like a champ, so the doctors said it was probably colic. NO, it was acid reflux without the usual signs like spitting up. She spit up a little bit but nothing abnormal. At 3 months we got her on baby zantac and it changed everything.